Introduction: My Experiences

About six years ago, I developed increasingly severe pain near the base of my tongue after an acute bout of laryngitis. It progressed into an extraordinarily painful episode that felt like I was being burned, electrocuted, and having a muscle cramp all at the same time. The pain was so severe, I felt like my throat was tearing in two. Subsequent episodes felt less burning, and more crampy/electrical, so I don't know if anyone else has had those sensations.

Anyway, I have a prior history of depression and social anxiety/phobia well documented on my medical records starting since early childhood and almost every time I've sought help from the medical community this either starts as a 'the suspicion' and grows progressively throughout the doctor patient relationship or is outright blamed as the cause from the start. I've had people try to repeatedly give me anti psychotics (not at all schizophrenic and very present) SSRIs, and a whole bunch of other irrelevant medications for 'pain.'

With doctors abandoning me and 'blaming me' left and right.I did a lot of research on the internet, what might cause pain. Finding glossopharyngeal neuralgia seemed very promising and seemed most likely of anything, but my experience differed a lot from the textbook experience. I have pain all of the time. Likewise, speech is impacted just during the major episodes, and I was mute for at least 2 years as it was too triggering to speak and was on an all liquid, luke warm diet as it was too painful to eat.

I managed to leverage a situation where I got medications that help me, in spite of no diagnosis and multiple people assuming I'm crazy. After reading about pain management, I got duloxetine, which which could be emphasize that it also treats mental illness too, right? I discovered valium was helpful during a trip to the ER and it was prescribed for awhile, but then suddenly taken away, saying they weren't comfortable prescribing a 'controlled' substance for someone 'like 'me' without more 'information.' When the med was taken away, I wen through horrific withdrawals and had the horrifically painful attacks every day, along with panic attacks too. So when seeking help for this i was told I was not only having 'emotional episodes and suffering from conversion disorder' but was also likely a drug seeking 'addict.'

I was ready to throw in the towel on the medical community, but I saw a sympathetic neurologist recently, who suggested it most likely is glossopharyngeal neuralgia, but he wasn't an expert on it and didn't feel he had the authority to give a definitive diagnosis. I'm going to be seeing some higher tier specialists soon who have more experience in pain. I'm hoping someone with authority can try to help me and stop blaming me. I just want to try to survive this thing, and it's incredibly difficult when people find any way they can to blame you. Going by all of the things that have been assumed of me: I'd have to be a psychotic, selectively mute, hysterical, drug addicted, malingering, and a liar all at the same time for these 'medical experts' to be correct. I'm pretty confident I'm none. I've got bad pain near the base of my tongue. Yeah, I've had depression, and I've been very suicidal at points in my life, but I don't want to kill myself over this, I want to survive this.

Thank you for this site and forum. I feel like it's been really informative and I think the experiences offered by people here are incredibly valuable, especially in a world where it seems like pain is ignored, denied, and blamed on the sufferer. I can't guarantee I have the same condition you all have, but I know it's horrifically painful and if it is at all similar, you all have gone through hell.

And even if I don't have this precise condition, know I've asked these doctors, why does it have to matter 'why' someone has horrific pain, anyway? If there's something that can be done to help someone with agonizing idiopathic pain. Why does this need to fit into a neatly labeled box to justify itself? I don't get it at all.

I knew within a few months what was my problem. Mine was left sided.

It would be triggered by various actions, the pain would last about 5-10 minutes. It was horrible.

This would go on for a couple of months, off and on for 6 years before I went to a neurosurgeon who operated (he did an MVD) and the pain was gone. I’ve had 2 pain free years. Although things in life still bother me, they’re not as bad as the GPN pain. Medications helped briefly.

I don’t know if your condition will be helped by an operation. But it won’t hurt to talk to a neurosurgeon who knows what to look for. My old MRI showed the blood vessel putting pressure on my nerve, but the Dr’s office told me usually they don’t see the vessel, and he operates on the symptoms.

Good luck, I hope you find some relief from this awful problem.

There is always hope! My suggestion is to see a neurologist and try anticonvulsants asap. If it is GN, the pain should be relieved in a matter of days. Narcotics did not touch the stabbing pain in my throat that I would feel with each swallow. The pain left me unable to speak. After the pain episode, there was a painfree refractory period when my nerve was so depleted that I could shove food/drink down in a hurry. It was very hard to prevent myself from swallowing saliva which would precipitate an attack. All I could do was lie on the opposite side on the couch hoping not to have to swallow. I was also getting attacks of trigeminal neurgia in my lower jaw. I had successful MVD of CNs 5,9&10 3 years ago and count my blessings daily. We are here to help and provide hope when noone seems to understand. It is truly a matter of finding the right doctors and doing your own research. Good luck. Don’t give up!

I might add that some cases of neuralgia might be caused by MS and in that situation I am not sure if anticonvulsants are as effective.

Thanks everyone. @Vicdoc, I'd be especially terrified of the operation as I was and still am a singer when I can be. The hoarse voice syndrome sounds terrifying and would be a huge loss, but I'll be open to whatever options they will offer me.

@Sallly, I did get to try gabapentin which is anti convulsant. Going on it didn't seem to help much, but going off was immediately followed by one of the episodes which may or may not have been related. I also convinced a neurologist to let me try carbamazepine, but it was conflicting with the diazepam and sending me into withdrawals so I couldn't accurately judge its effectiveness.

When on both duloxetine and valium, I regain a good portion of my voice, can eat solids, and don't have the really severe attacks. There is still constant pain, and every day is a challenge, but its just dialed down.

Another thing that varies from the textbook definition of glossopharyngeal neuralgia is duration. When one of the major episodes really gets going it can last for hours. Has anyone else had a longer duration than a few minutes? Whatever it is, it's extraordinarily painful beyond anything I've ever experienced.

You’re in a tough place. I was very hoarse for months, and even now I sound gravelly sometimes. There are some who end up with a paraylised vocal cord on one side. And some are worse off.
It can be permanent.

On the other hand, I was willing to risk my life with the MVD, and I have no regrets. I have my life back, and I pray it stays this way.

Only you cans weigh all the options and risks. You need to talk with an experienced neurosurgeon and find out more.

I also never felt anything quite like this pain, although an attack would last only minutes, I could have dozens a day. I still get terrors sometimes thinking about the pain. But that’s behind me, for now, and hopefully for the long term.

Best wishes in your journey, and hope for a pain free life.

So much written in the felt to discussion, is applicable to the way I experience g.n. Pains. In brief, the pains I have experienced have been agonising. I too have never experienced such terrible pains. In fact I never realised such awful pain existed until i too suffered GN pains. Like the last writer I too get terrors just thinking about the pains, luckily at the moment my pains are being held back by the talking of Carbamazipine. I am currently still awaiting an mri and a 3 d Ct scan. Luckily I am now being seen by some of the UK’s leading neurolgy logical people . I was told by oneof these neurolgy consultants recently, that they will only ever see a person havingglossi bray veal neuralgia perhaps once or at the most twice in thEurope life.wheras lots of people have trigimenal neuralgia, very, very few have glossophrayngeal neuralgia. I think it is because this condition is so rare,mdoctors normally know nothing about it and have no experience of it. So cannot identify it and/or do not know how to treat it.

Best wishes to,all those who suffer from GN. May you all find specialists who can properly help and treat you and let us all continue to raise the profile and medical knowledge of this profoundly painful and life changing condition.



Vicdoc said:
You're in a tough place. I was very hoarse for months, and even now I sound gravelly sometimes. There are some who end up with a paraylised vocal cord on one side. And some are worse off.
It can be permanent.

On the other hand, I was willing to risk my life with the MVD, and I have no regrets. I have my life back, and I pray it stays this way.

Only you cans weigh all the options and risks. You need to talk with an experienced neurosurgeon and find out more.

I also never felt anything quite like this pain, although an attack would last only minutes, I could have dozens a day. I still get terrors sometimes thinking about the pain. But that's behind me, for now, and hopefully for the long term.

Best wishes in your journey, and hope for a pain free life.

My pain is currently doing the fun "just about all the time" thing. I occasionally have moments during the day when it feels great. But most of the time lately, I range between bad and worse. I don't know if it is the weather (colder) and/or having just weaned off the gabapentin (after having some help from epitol), but I have a call in to the neurologist, and hope they call back today. (I called Friday. Sigh. They are not usually too prompt these days.) If I don't hear back today, I will call tomorrow. I suspect I need a higher dose, or to add the gabapentin back. And maybe would benefit from an antidepressant. (I've read that tricyclic anti-depressants can help, and either from the pain and/or the epitol, I think I am mildly depressed right now. Not my normal state, by a long shot. I'm a PollyAnna type.)

Good luck on finding the solution that works for you.

Hi MOF,

The tricyclic anti depressents work really well on the "atypical" burning boring types of pain and can be used with the anti epleptics.

Smiley.

Hi MOF, I have atypical constant pain. Feels a bit more electric than burning though. Duloxetine (Cymbalta/SNRI) seems to help which is similar to the tryclics in that both are serotonin and norepinephrine reuptake inhibitors. Tryclicics have a bit more effects in calcium, sodium, and potassium blockades, which are used in some anti convulsants, and may have more power however.

I'd highly recommend trying a tryclicic or SNRI if you have any kind of nerve ish pain. Just know that duloxetine is extremely difficult to quit both from personal experience and mounting scientific evidence. the FDA has issued a warning about this, and there is even a class action lawsuit against the manufacturers for posting very misleading studies about the effects of withdrawal. If I miss even 2 pills, it hits me hard (pain through roof, lots of anxiety).

So in retrospect, I might lean towards trying the tryciclic first, see if you can handle the side effects, then bump down to the SNRI category if the side effects are too much as they are potentially harder to quit without as many ways of blocking the nerve signals.

Thanks. A couple days ago, I started on duloxetine, too, along with the epitol (generic Tegretol.) I didn't know about the difficulty with withdrawal, though. I knew that with an SSRI (my son had been on one a couple years ago) that you have to both step up and step down, but he had no problems with that. I am taking what the doctor prescribed, since I really don't have a lot of say in it. Heck, I haven't even seen him since April, just talk to him through the nurse aka gatekeeper. :-)

The pharmacist did say it takes 3-4 weeks to start taking effect, though, so I'm not expecting a quick fix.

I remember when I was taking gabapentin, I missed my night (two pills) dose one night, and could NOT sleep. Finally, around 6am, it dawned on me that I'd forgotten that. Oops. I didn't do that again. (And weaning off it wasn't too bad, thankfully.)